George is referred at age 6 years 6 months from family pediatrician to a pediatric endocrinologist for poor statural growth and some facial dysmorphic notes. Second child of non consanguineous parents. Older sister is in good health. Father 177 cm tall, mother 161 cm, menarche 11 1/2 years. Genetic target cm 175.5 (50° pc). No major pathologies in family history. Pregnancy passed regularly, induced delivery at 39 weeks due to fetal distress; neonatal period progressed without complications. At birth kg 2650, cm 49. Head circumference unknown. According to the mother, growth in the first years of life was regular. Modest delay in psychomotor development: first words after one year, independent walking at 17 months. He is followed in Child Neuropsychiatry for “developmental delay and mild intellectual disability (IQ :63) and behavioral problems” and is undergoing psycho-motor physiotherapy treatment. He is also being followed in Broncho Pneumology for episodes of bronchial asthma and by ophthalmologists for modest strabismus. The parents report that George, seen at age 5 years and 6 months, had a stature of 101.9 cm (3° pc), a weight of 17.5 kg, and a bone age 4 years and 6 months. Given the dysmorphic facial notes, two geneticists had been consulted who did not make a diagnostic suspicion. CGH array was negative. On objective examination (6 years and 6 months), general and nutritional conditions are good, preserved limb/trunk ratio. Some modest facial dysmorphia, mild strabismus and modest delay in cognitive development are noted. Examination of the various organs and apparatuses is negative. Height 107 cm (3° pc, 10 cm below genetic target), weight 21 kg, BMI 15 (25° pc). Bone age found to be 5 1/2 years (1 year below chronological age). The pediatric endocrinologist decides to recheck statural growth at 6 to 12 months. In fact, the child is revisited at ages 8 and 4 months. The period between the two visits has progressed without any particular events. Dysmorphia persists, regular trunk/limb ratio, prepubertal genitalia. Height 123 cm (10° pc, within genetic target), weight 25 kg, BMI 16.6 (25°-50° pc), head circumference 52.5 cm (50° pc). Bone age: 10 years, almost 2 years higher than chronological age. Conclusions: stature at low limits of normal, some dysmorphic notes, modest psychomotor and cognitive delay, rapid acceleration of bone age, which at age 5 ½ years and at 6 years 6/12) 1 year lower than chronological became at 8 years 4 months almost 2 years higher resulting in worsening prognosis of final stature (see Figure 1).